Serum testosterone levels of HbSS (sickle cell disease) male subjects in Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>Infertility is a major problem in sickle cell disease patients, especially in males. In addition to low serum testosterone, other abnormalities involving the accessory sex organs, such as the seminal vesicles and the prostate gland, as well as marked decrease in ejaculate volume may be observed in male HbSS patients. Hence, the need to study the role of sex hormones as a cause of infertility in male HbSS patients.</p> <p>Methods</p> <p>An unmatched case-control study was performed using seventy-five consenting subjects from Lagos University Teaching Hospital. These included 47 patients with haemoglobin phenotype SS from the Sickle cell clinic and 28 volunteered medical students and members of staff with haemoglobin phenotype AA. Demographic data were obtained using a self-administered questionnaire. A total of 5 mls of blood was collected from each subject between 9.00 am & 11.am, and assayed for serum testosterone concentration.</p> <p>Results</p> <p>The concentrations of serum testosterone in HbSS patients ranged from 0.2 to 4.3 ng/ml with a mean of 1.28 ± 0.72 ng/ml whilst the values in HbAA controls ranged from 1.2 to 6.9 ng/ml with a mean of 2.63 ± 1.04 ng/ml. Seven (25.0%) of the 28 controls had serum testosterone concentration lower than the quoted reference (normal) range whereas 44 (93.6%) of the 47 HbSS subjects had serum testosterone concentration lower than the reference range.</p> <p>Conclusion</p> <p>Overall, subjects with HbSS have significantly lower mean serum testosterone than HbAA controls.</p

Sickle Cell Pain Crisis In Adults: An Assessment Of The Management By Medical Practitioners In Nigeria

Background: Sickle cell pain crisis is a common medical emergency in Nigeria. The treatment approach to this common problem is known to vary amongst medical practioners. Subjects and Methods: A cross-sectional survey of one hundred and seventy-four medical practitioners was carried out using a questionnaire. They were interviewed concerning their mode of treatment of sickle cell pain crises. Information obtained included professional qualification and date, field of specialization, number and severity of pain crises attended to, choice of analgesics in pain crises, type and quantity of fluid, use of anti-malarial drugs and antibiotics in pain crises. Results: Their experience ranged from 2 to 34 years. 65 (37.6%) were within 5 years and 108 (62.4%) would however not prescribe narcotic analgesics even in severe pain crises, for various reasons. As many as 38 of 174 ( 24.2%) would give inadequate quantity of fluid and 18 of 124 (14.6%) will not give antibiotics even in the presence of markedly elevated white blood cell count, 45 of 90 (50%) will give anti-malarial drugs routinely. Others will give anti-malarial drugs only if there is fever. None of the doctors will insist on a laboratory demonstration of malaria parasitaemia before giving anti-malaria drugs. There was no statistically significant difference in the management of pain crisis by doctors who were within 5 years when compared with those above 5 years post-qualification. Conclusion: Although, 70-80% of the doctors manage pain crises appropriately, it would be desired that all doctors manage sickle cell pain crises properly. To achieve this, a pain management protocol may be introduced in order to ensure that every sickle cell pain crisis is appropriately and consistently managed. Key Words: Sickle cell, pain, crisis, acute complications and management. Nigerian Journal of Clinical Practice Vol.5(2) 2002: 109-11

Prenatal Diagnosis: Appraisal Of Awareness And Utlization Among Health Workers In South Western, Nigeria

Objective: To appraise the level of awareness about prenatal diagnosis among health workers in southwestern Nigeria and its utilization. Methodology: Questionnaires were administered to 270% were in randomly selected from private and public health institution in south western Nigeria. Result: The distribution of health workers showed that 6.3.7% were in public and 36.7% were in private health institutions. Generally, majority (55.5%) were aware of prenatal diagnosis. Only 95 (35.2%) respondents were aware of the existence of a prenatal diagnosis unit in Nigeria. The present level of awareness was considered inadequate by 195 (72.2)% respondents. Major ways of improving the awareness and utilization were through its incorporation into undergraduate training curriculum (31.5%) and academic programme (23.1%). Majority (78.2%) of health workers have never referred patients for prenatal diagnosis in Nigeria. Low level of awareness (48.0%) and high cost of service (28.0%) were the constraints most frequently identified. Conclusion: The awareness of prenatal diagnosis among health workers in south western Nigeria is grossly inadequate. Similarly, its utilization is poor. Ways of improving on this is suggested. KEY WORDS: Prenatal diagnosis (PND), awareness, utilization Nigerian Journal of Clinical Practice Vol.6(1) 2003: 46-4